1.Meeting Information
On 26 September 2025, Day 3 of SBNS 2025 at Ashton Gate Stadium, Bristol, the 08:30 industry breakfast sponsored by Severn Healthcare focused on “Medprin Dural Patches — the UK experience.”
The session was chaired by Nigel Mendoza and Sam Hattige. Two speakers shared UK data and experience: Kevin O’Neil (Imperial College Healthcare NHS Trust & Cleveland Clinic London) presented “10 Years’ Experience with ReDura,” followed by William Singleton (Bristol Royal Hospital for Children & UHBW) on paediatric duroplasty (reported separately).
2.Redura Experience shared by Kevin O’Neil
A. Position & overall appraisal
Repair philosophy: restore the anatomical barrier—leaving the dura unrepaired may increase risks of CSF leak, impaired healing, and infection in specific scenarios.
Material rationale: autografts are limited; allo/xenografts raise ethical/immunologic/pathogen concerns; non-resorbable synthetics carry foreign-body issues; thus resorbable synthetics best approximate an “ideal” substitute.
B. Redura® — material & handling
Engineering & material: electrospun PLA non-woven; slightly elastic, hydrophobic, aiding watertight closure and suturable handling.
OR behaviour: resists tearing, trims/holds sutures well under tension/CSF gradient; low adhesion to brain favours safe re-entry.
Biologic course: host dural ingrowth with resorption; routine experience suggests low inflammation/infection signal.
C. Indications & scenarios
Large dural defects (tumour, infection/attenuation, trauma/prior surgery);
Dural augmentation or high CSF gradient (e.g., posterior fossa, periventricular);
Intradural spinal closures;
Watertight-critical contexts (e.g., ventriculostomy, with brachytherapy/chemowafers) and revision cases needing non-adhesive, re-entry-friendly patches.
D. Representative cases (as shown)
(1)Massive cranial defect in revision (patient from Sudan)
Persistent large dural gap; tried other product to overlay, attempts tended to sink.
First use of Redura® cut-to-fit achieved stable barrier;
operative takeaway: choose overlay vs underlay strategically by location/forces.
(2)Dura-involved tumour
Thickened enhancing dura with a pinhole and blood ingress risk.
Sutured + overlay to block ingress; good closure achieved.
(3)Temporal tumour extending into the temporal horn (“valve effect”)
Dynamic CSF gradient and tissue stretch.
Surgeon’s comment: Redura®’s elasticity & suturability feel as good as—or better than—autograft for a controlled watertight repair.
(4)Re-entry experience
On recent returns to the field, the patch showed low adherence to brain, aiding clean plane dissection.
E.Evidence and follow-up
A prospective RCT demonstrated non-inferiority to a synthetic comparator with very low CSF-leak rates; the principal limitation was ≈6-month follow-up, yet no device-on-brain safety signal emerged. Animal data indicate ≈12-week dural-cell replacement/integration.
F.Practical checklist
Closure strategy: suture-secure, watertight first; add sealant as reinforcement, not as a replacement for sutures.
Prioritise for: posterior fossa/periventricular, large defects, intradural spine, and revision surgery needing strength + low adhesion.
Pathway & QA: standardise sizing/suture/sealant; track CSF leak/infection/re-op/LOS for continuous quality assurance.
G.Bottom line
A resorbable, suturable, hydrophobic, low-adhesion patch with ten years of UK use, ReDura® is well-suited to high-risk watertight closures and fits a “suture-first, sealant-as-adjunct” philosophy.
Next (Part II): William Singleton on paediatric duroplasty—child-specific anatomy/physiology, closure tactics, and CSF-related complication prevention.